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Wednesday, August 29, 2012

MiM Mail: Two doctor families

Hi MiM community,

I discovered this blog fairly recently and I
think it is really wonderful that this community exists. However, I
haven't seen very much here or anywhere (online or in life) by women who
are part of two-doctor/medical student families, which is my situation.
I am a mother of one, in my third year of medical school, and married
to a first year resident. To say the least, my life is very busy. At
least when we were both studying all the time our hours were flexible!
We're fortunate enough to have both of our families close by, and we
have amazing childcare. It really hurts that I see my child so rarely;
he spends most days and some nights with one of two babysitters and our
families, which often needs coordination on my part, but he loves them
all so at least I know he's happy. So far, he seems to be handling the
changes in our hours very well; I think I'm more upset by not seeing him
than he is. We're slowly making adjustments to our life to make it more
possible to keep everything going somewhat smoothly.

But, what it comes down to is that I'm completely overwhelmed by
this new situation. I'm also uncertain that I and my family will make it
through to the end of my training - I have at least five years to go
and I just can't imagine continuing in this way for so long (or even
longer if I want to do a fellowship.) I know that medical school and
residency are incredibly hard and that this is an investment in my
future, but I'm frustrated with my life and how it seems so out of
control. Also, I don't think that I'm living up to my own standards of
what a good medical student and a good mother/wife should be - both of
those roles force me to sacrifice part of the other so in the end I feel
mediocre at best in both. Having my husband often out of the picture
thanks to his crazy schedule doesn't help either - I sometimes feel
(almost, since thankfully I don't really know what it's like) like a
single mother.

I'm sure part of this is the adjustment to a major change in our
lives and our schedules. For all I know, this is typical of two-doctor
families who are going through training together. This is the also the
first time that I've had to confront the challenges of the 'work-life
balance.' But I'm starting to wonder whether maybe I'm not cut out for
this and should look at alternate careers (I wouldn't leave medical
school at this point, but I'm really having doubts about doing
residency). In any case, it would be great to hear from people out there
who have dealt with or are dealing with a similar situation, or really
anyone at all. Thanks!

33 comments:

I don't have any good advice, but I'm looking forward to reading the comments. I'm a first-year medical student, and my husband is an emergency physician who is also chair of his department; we have two children. Our life is often a 3-ring circus, but somehow everyone seems to be doing okay.

Both sets of our parents live close by and are quite helpful. My elder child is in elementary school and gets picked up from the bus by a grandmother or babysitters every day. My younger is in pre-K/daycare. The funny thing about my husband's job is that, as crazy as his administrative work is, things seem much better now because he has some control over his schedule.

I, too, sometimes have that feeling that I'm just not doing anything well. A lot of that is my unrealistic, perfectionist expectations of myself, and when I let them go, things are much better. (But that's easier said than done!) It's not going to kill my kids to have frozen pizza for dinner, and it's not going to ruin my career to get a C in a class.

It's hard sometimes looking at my young classmates who are so carefree and have complete control over their schedules. But then I walk through the door at the end of the day and I'm a rock star--I am greeted with such love and excitement and hugs and kisses, and I wouldn't change where I am in life for anything. My kids ask for an update about anatomy lab every day, and my younger sits and looks at flashcards and atlases with me on a regular basis. Because I am a student again, and struggle at times, I can relate better to my older child as she goes through school. Last year, she was upset about a worksheet, and I was able to show her a physics test that I bombed. We talked about how sometimes we can try our best but not do as well as we wanted. So, we learn from them and move forward. I don't know what they understand exactly about what it means for me to be in medical school, but one thing that I hope they take away something positive from their mother's pursuing a dream/calling.

Perhaps I am still naive, as I am at the start of this journey. I know that it's going to get harder, and there will be times when it won't seem worth it. It's hard to keep perspective when things spin out of control.

Sorry for the ridiculously long comment . . . I can't wait to hear from other 2-doctor/resident/student families. :)

I don't have a 2-physician family, but I was also at a point a while ago where I didn't see how I could make it through a residency due to the grueling schedule.

My advice is not to give up on medicine, but maybe to look for a residency that has better hours. Not all residency programs are grueling. I did a residency in PM&R, and at worst, I'd be at work from 8AM to 6PM. Those were really bad days. On some rotations, I'd only work from 9AM to noon. I took call from home, and worked only one weekend every other month. Not bad!

Of course, you shouldn't pick a field just because the residency is easy. But residencies within a specialty can vary in difficulty. And if all the residencies are hard, that may be an indication that you're going to be working hard for the rest of your career.

That's definitely something I'm thinking about - I'm doing a surgery clerkship now and while I enjoy it there is no way that I would put myself and my family through that kind of training and that career. Hopefully I'll find something that works for me but it's difficult to imagine what that would be like when things are so crazy now.

I know a few 2 physician families, and usually the wife works part time while the husband works full time - the standard gender roles. There are a few instances where both work full time. In one family, the husband is an endocrinologist and head of the fellowship program while the wife is the head of the homeless psychiatry program at her work. They have no family, but use babysitters and aftercare, and basically split childcare duties. In another family, the husband is an ID attending and the wife is the Med Peds program director and they also use babysitters a lot. In another family, both husband and wife are in an internal medicine practice. They take turns to be on call and have good babysitters.

The stress and exhaustion from medical school and residency WILL ease up if you are in the right job setting. Honestly, I believe that's why a lot of women (and men) choose certain residencies - the "lifestyle" residencies are the most coveted ones. There are many jobs that allow for more flexibility, potentially part time, or even just 40 hours rather than 70-80 hours a week.

Moreover, residency has gotten a lot cushier compared to before. New work hour rules went into place (I thought they were fabulous when I was a new resident, but they're even better now!!), and in fact, most programs (Internal Medicine and Pediatrics, anyway) have some kind of night float system that makes it so overnight call is not as frequent as it once was.

It's funny that you mention families who have the wife working part time - that's exactly what I want to do. Unfortunately the road to get there requires working the equivalent of two full-time jobs...the cushier residencies would be great but they are just so competitive that realistically I probably wouldn't match into them.

I am not part of a 2-physician family, but I know many, many, many of them - it almost seems to be the exception rather than the rule sometimes!

Your situation is definitely not easy, but the family support means your child is getting the love and care he needs!

I have known a handful of women to take a break between medical school and residency to raise small children, so that might be something to consider.

My first child was born in November of my intern year in Internal Medicine (before hours limitations). That was the hardest year of my life. I ended up switching to Pathology residency at the end of that year, out of desperation. At least in my path residency, it was a mostly 8-5 M-F schedule. No in-house call. And the only time I was ever called during home call was during my month on Blood Bank. Fortunately, I am infinitely more suited to be a pathologist than an internist, so it was all a blessing in the end.

Although hyper-competitive, dermatology residencies are also less grueling in terms of call (although you do have to get through an intern year first). So there are some options to consider.

Good luck. Women, no matter what our career path, often struggle with feeling like we are falling short in both areas - professional and personal!!! We should cut ourselves a little more slack.

I am not part of a 2 physician household, but I am an Intern and I work longer and harder hours than I ever did as a Medical Student. I am in Pediatrics (less taxing than Internal Med/ Surgery) but definitely still difficult. My husband is a Graduate Student and we both worry about being able to manage with our schedules. Another mother Resident and I were recently talking about how we would be part-time residents if we could. I am going to be honest, the hours, especially with a baby are the hardest I have ever had! I don't want to dissuade you from following your dream, but you must be realistic about your schedule. Think medical student schedule times at least 2 or 3 because you are actually "in charge"/ accountable. It's great that you have family support. Set your priorities. Perhaps you or your husband can take time off from training in order for at least 1 parent to have a stable schedule? Being with family and friends is okay, but I really think having a parent around regularly is for the best.

OH and before I forget, 4th year is definitely the "easiest" year of medical school so you are almost done with the crazy part of med school. What about a Research Fellowship for a few years until your husband is done with Residency and your little one is older?

I think that part of the reason that things are so out of control right now is that I'm in the craziest year of med school and my husband is (hopefully) in the craziest year of residency. But a research fellowship is an interesting idea - thanks!

I have a husband with a very flexible home-office law job, and to be honest I was secretly jealous of the two-physician couples I knew in residency. At least the other spouse understood the out of control nature of residency schedules, whereas my relationship went through rough waters due to our vastly different work situations. You are right to think hard about these issues now, consider your specialty choice and/or the possibility of doing a research year... because residency is MUCH worse than med school in my opinion.

I'm part of a two-physician family as well. My husband is a pulmonologist/intensivist and his hours are horrid. I found (similar to you) that I wasn't happy while I was working full-time for multiple reasons. Some were obvious: I was exhausted and cranky after a full day of work (although primary care is easier than many specialties, I still found myself struggling to get home before day-care was over), I would take it out on my children and my husband; I was unhappy as I didn't feel I was giving either aspect of my life the attention needed. Part of this was because my husband was unable to help out very much because of his crazy schedule. I finally chose to go part-time (I only work 2 days a week now), and we are all much happier. It took a lot of soul-searching to get to this point and some amount of mourning over the loss of the career I had envisioned, but it has been worth it in spades. My husband and I had a lot of discussions which one of us should rearrange our schedule, and I was surprised to realize I wanted to be the one to work less. I am very happy with my decision now. I stay in practice enough to keep my skills up without burning out quickly. I am able to easily volunteer and my children's school and help them out with homework. I know several two-physician families who both work full-time and are able to make it all work beautifully, but I found this scenario to be better for my family.

So my advice would be to seriously decide with your husband what you envision in your futures and what sacrifices you are both willing to make to achieve that vision. If you go into a life-style friendly career, you will likely find it easier to work part-time and have some flexibility in your schedule. They also tend to be shorter than the super-competitive residencies. Stay close to your family because that type of support-system is invaluable.

I think having one of work part-time down the line will make things much better - my husbands hours are so crazy that I'm also left doing most of the work at home along with a third year schedule. Although, if we both end up in 'lifestyle' professions, maybe we'll both be able to stay full-time. Either way, it's so good to hear that this can be done!

I'm not yet a physician, and my husband is not a physician, but we both worked very demanding jobs. I was and still am taking my pre-med classes. We had to decide for one of us to take a step back careerwise. After I came off of maternity leave, he took a stable government role that kept his skills sharp but was limited to a normal workday. My point is this: Be careful you aren't the only one making career sacrifices and that you are comfortable with those choices. The choice between career and family shouldn't be limited to the mom.

Once you make it through residency, you will have control if you want it. I work part-time in a family medicine practice out of a home office; I have loved it. My husband and I went through med school together, which I do think was easily on our marriage than our fellow students with a spouse in a different career. But we were able to choose to have our first child at the end of my residency.

Most people in the world would love to be able to have the options we have, but of course, residency isn't too flexible. When I was going through the match, way back in 1991, there were a few family medicine residencies that offered shared positions. i don't know how those options are now, but worth checking into.

The recent study on burn-out is also interesting and is worth reading. Now my oldest is off to college in a few weeks and I am incredibly happy that I never worked "full time" since she was born.

So, I am a physician married to a physician and we have 3 kids. Our families live far away--the closest is about a 9 hour drive--and visit rarely. My husband is active duty military and has deployed 3 times since our second child was born. We have made it work in various ways, though it hasn't always been easy. When we had our first two kids, I was a fellow (in medical oncology at a top-rated program, so definitely not a "lifestyle" specialty or a program with light hours, but we were helped by the fact that I was in my more flexible research years when they were born) and he was a resident. For the last 6 yrs, I have worked part-time in medicine 3 days/wk. We have never had more than 25-30 hours of childcare per week. We have made this work in a variety of ways as our situation changed. When we were both in training, we shifted our schedules so that I went early and came home early or went late and came home late (opposite whatever his rotations required, to the extent possible...I could do this since I was doing research) and used the childcare to cover the middle. I will admit freely that it did involve computer or dictating work in the evenings from home often, sometimes many hours of it, once our kids were in bed, but we were committed to having that face-time with our kids, so we did it. You are fortunate that you have an involved family network to fall back on.

After I started working part-time--which has been our family's salvation!--we simply have had childcare the days I work, although we still do some shifting of my vs. his hours as before to keep our total childcare to 25 hrs/wk. I also chose a work setting (in government) that meant my hours were more predictable and circumscribed.

If you look under my MiM posts (tagged Tempeh), you'll find one I wrote about How to Get a Part-time Job in Medicine that may offer some help or insight for you looking long-term. I personally think that working part-time is ideal for physician parents (men or women) and can be made to work in any specialty with enough persistence and creativity and the right employer.

First of all, thank you for your and your husband's contribution to our country. If I could ask - did you also have only 25-30 hours of childcare/week when you were not in research years? I wish we could shift our schedules so that our son doesn't need as much childcare but we're not really in that position yet. I've seen a few times now that having one spouse work part-time really makes a big difference, so I'll definitely keep that in mind. Also, it's good to see a physician working in a less traditional setting - I've thought about doing that as well but don't see many people doing it and haven't found that much info on the internet. I'll definitely check out your MiM posts - thanks so much for the support!

I am an anesthesia resident and my husband is an internal medicine resident, planning to do a cardiology fellowship. We are both PGY-3s so we've been a 2-resident household now for awhile! We have 2 kiddos, 3 months and 2 1/2 years old. It is quite a juggling act to coordinate all the schedules, but I really feel quite content with our life right now. Sure, I'd like more sleep, but wouldn't everyone ;)?

I think your comment about feeling like you have no control is very common among medical students. You get a lot more control once you're a resident, and presumably even more once you're an attending. I remember being a medical student and feeling like I could never leave my residents' sides because they might disappear! And then I'd be alone! And what would happen then?!

Now, I do things independently, go home when my work is done, and it's just so much better than being a medical student! So, I think that feeling will get better with time.

Also, the biggest things that have helped me as a 2-resident household is outsourcing anything I can. We have someone who cleans twice a month. Our nanny is also available to help with laundry, light cleaning, or other errands as needed depending on how busy we are. We do also have family help in the area which is indispensable. It really takes a village to raise a child, and figuring out who to get in your village may be hard, but once it's built it will be so helpful! Good luck!

http://theunderweardrawer.blogspot.com/ tells the tale of a two physician family on their third child, and they had their first during...residency? Maybe, I can't remember. But worth a read on how she juggles it, and both work full time. If you have the time, read it from start to finish, and she's pretty good about returning emails if you have questions for her.

I'm going to be the lone voice of dissent here, maybe: think hard about whether, and how much, you want to be a physician. If being a physician is where your heart lies, it can be combined with hands-on motherhood in all the ways you've heard: part-time work, careful selection of residency and job, outsourcing non-essentials. If, though, you're in med school out of default like I was (I'm a smart kid, I like science, this is a good next step), look a little more closely. While I enjoy my current job as a physician and am doing all the things that make it possible for me to still be an involved mother and a full-time doc, if I could go back in time? I wouldn't go to med school. I'd do something far less time- and money-intensive, and I'd feel free to stay home with my babies when they came. Because, honestly? That's what I wish I could do right now. My eldest is 13, and he needs me at home more now than when he was a toddler.

HI! Hang on! You and your husband are at the hardest parts of med school and residency...and now you have an active little one!!! It gets better. I am half of a 2 physician marriage with 2 daughters now 12 and 10. We had our first daughter our 3rd year of residency.See if you can take some time off...a research elective that would normally go in your 4th year done now....split your 3rd and 4th year into 3 years. Most schools will work with you. Burn out is not a pretty place to be as a person, spouse or mom. Now is the easiest time to take time out and slow it down. No one is dependent on you to take call or care for patients. Does it really matter if you match to a residency one year later? Think about this option please! That way you will be starting your internship rested and hopefully with a spouse who is is past the crazy years of his residency. All of this can be done but it may not "look" like what you thought it would.....welcome to parenthood and life in general! BIG SMILE.I have always found that amazing and unexpected opportunities open up when I am willing to be open to them. Just because everyone else does medical school in a certain number of years doesn't mean that it is the only way to do medical school or the right way to do medical school..especially for you! Don't focus too much on the future right now....think about what would make this year work for you! Treat yourself with the care and compassion you hold for your patients . Many blessings!

I thought I posted something here earlier, but now I don't see it so I'll try again. Apologies if there is a duplicate.

I'm going to be a little voice of dissent here and ask that you think carefully (as I'm sure you are) before plunging ahead. Yes, being both a good doc and a good mom IS possible but that doesn't mean it's for everyone and it doesn't mean you shouldn't re-evaluate your career path if and when circumstances change.

If practicing medicine is where your heart lies- if this will bring you happiness and contentment and allow you to bring your talents to the world in the way you want to share them- then go for it. The struggles now will be worth the payoff later, and the sacrifices you make will be less important than what you've gained.

IF, however, you (like me) find yourself in medicine as a sort of smart-girl default (I'm a star student, I like science, this is the logical next step for person like me), please think again and don't rule out leaving medicine (or clinical medicine, at least) just because it would seem to be quiting or admitting defeat. It is neither- it can be more courageous to leave something you know is not suited for you and your lifestyle than to stay. (Please note I'm NOT AT ALL saying this is the case for you- I have no idea.)

I work full time now and have kids and while I really do enjoy my work, if I could go back in time, I would not go into medicine. I wish I would have listened to the little voice inside that told me to QUIT NOW when I had my first, during my first year of residency. I would choose something less intense in time and mental focus that would allow me to quit when my babies came along, which is honestly what I wish I could do right now. My husband gave up many career opportunities and so much career potential in order so that I could focus on mine- as a result, it is now much more difficult for him to find work that could support our whole family and still save for retirement/college. So I continue working- but my eldest is now 13, and he needs me more now than when he was a toddler. I'm doing well at work, but my heart is in my home and my family and I wish my body could be there as well.

I am an Ob/Gyn married to an Anaesthesiologist/Intensivist, now 7 years out of residency/ 5 years out of fellowship respectively. We have a 3 year old and #2 en route. My husband's hours are hideous, and, on heavy month, he has done as many as 17 calls (mainly from home). To say that we have had challenges finding some balance in our lives is an understatement.

Our solution has been for me to not have a 'real' job. I have been working as a 'permanent locum' with a group of three Obs for nearly 5 years. I generally work 2 days a week, with 1 or 2 calls, and 1 OR day every 4-6 weeks. I essentially have my own little practice within a practice, and have patients that I see regularly, no matter which of the three I am covering for. We have been fortunate enough to find a live-out nanny who has another job that is happy to work around my schedule, and have family who are more than happy to pitch in when they are able. Though there are some drawbacks to not having my name emblazoned on an office door, they are more than balanced out. I never have to worry about working enough to pay overhead, as I pay a percentage of my billings, don't have to worry about finding a locum if I need time off, and know that if one of 'my' patients needs attention when I am not available, that she will be well cared for.

Would I do this all again? I'm not so sure. I wound up in medicine as a bit of a 'smart girl default' (as billygoat put it), and have questioned that decision every step of the way. However, I enjoy what I do, and feel very lucky that I have been able to have so much control over my work life, in the end.

We're another 2 physician family. I've been out in practice for just over a year as a family physician and hubby is a radiology resident. Our son is 3.5 and #2 is on the way :)

This life is HARD to do when still in training. There were a lot of tears (always mine) and self-doubt (Why am I DOING this??). However, the change in our family stress when I finished residency and had full control over my schedule was AMAZING. We went from a permanent juggle to rarely needing outside help.

In this hunt for some work-life balance, I changed careers from an internal med residency to a family med one and then slowly cut back my hours in the office once I joined a practice (balancing off paying off med school debt and being at home for my son). I only locumed for 6 months (to end the "when and where are we working this week??" issue) and found a practice that was very family-friendly.

I currently work 3.5 days and short days (930-330) so I can do drop off and pick up at daycare, AND get my paperwork done. Changing my last appointment slot from 4:45 to 3:15 meant I almost never finish charting or check labs from home anymore.I also cut out all non-essential extra-curriculars (left a board position, said no to several research projects) because when I was off, I wanted to be OFF.

For us, this has been close to utopia. Hubby still has little control over his schedule and his days can be long so it's nice that my job is a source of stability (both in income and in hours). Sure, I could pay down that LOC a few years faster if I was full time but my stress level would be immeasurably higher. I know hubby was glad he matched to a specialty he loved, offered a great income potential, and although busy, is still considered a "lifestyle" specialty.

Hubby will be looking for an academic posting once he's done - I expect he'll always work full time and have a "prestigious" job at a big centre, based on who he is... but I am OK with that. At 28, I wasn't sure that I would EVER be OK with slowing down and being the spouse that was stepping back in their career... I wanted everything to be equal and "fair".

However, I honestly don't feel the same way now (at 32, and now that our son is a part of our family). I still feel challenged at work, I feel like I can make a difference in my role, and I don't miss the madness of juggling call, research, board meetings, and clinical work. AT ALL.

It was a gradual evolution for our family and I personally needed to struggle a bit to figure out where my priorities lay. I'm so happy with our 2 physician life now... so I guess it's time for #2 so we can get some crazy back into our midst!

It's been great to see all the responses your letter has generated! I too, am part of a two physician family. My husband has- finally- started his first year as an attending (academic center), while I'm still whittling away as a second year GI fellow. We had our 1.5 year old son during my third (and lightest, workload wise, for me) year as an internal medicine resident. And I echo everyone's sentiments, that it's hard, especially during training. The hardest year for us was this previous one... he was in a surgical fellowship, on "home" call q2 (given the new intern restriction in duty hours, fellows got stuck taking all intern call), while I was on call at q3-q4. It took a lot of pre-planning for call (one of us was always at home at night, and on the nights we couldn't avoid the dreaded double call, we had a family member "on call" in case both of us had to go in- which actually happened pretty frequently). We were definitely a lot more irritable, especially on nights that baby boy decided he didn't like sleeping in his own bed... between the baby and two pagers, it was like qhs call. Things are better, now that he's an attending and I'm a second year fellow, but I came so close to losing it so many times (especially when I got paged "accidentally" for the nth time at 2am when I wasn't on call).

We thankfully also found fantastic childcare- our nanny is always extremely reliable and starts her days at 6am until "when one of us got home". She also does everything, including cooking, laundry, cleaning. I haven't touched a pot since residency, and we pay dearly for it, including my entire salary, and then some.

So that leads me to this point- You HAVE to love what you do, love your work, otherwise it's totally not worth it. I can't imagine doing anything other than this, and now that I've fallen in love with advanced endoscopy, it's even more training (which is a huge headache in itself)... but you should pick a specialty with a bit of "lifestyle" in mind, because certain specialties just don't lend themselves to parttime work (ie, neurosurgery comes to mind). However, don't just choose radiology/dermatology, etc, for the lifestyle, because otherwise, you'll be bored out of your mind. Part time is possible in many specialties, it just takes a lot of effort to find. But this - all of it- can be done with outsourcing and pre-planning, as others have mentioned above.

I suspect that things may change if we ever decide to have #2 (in terms of hubby and my career trajectories)/when our son gets older and I actually start thinking about jobs, but for now, husband and I are both having a great (yet very tiring/caffeine fueled) time. Our son is loved, well cared for, and we value every minute we spend with him (insert comment about quality > quantity here, etc).

Being a child of a two physician family myself, I can tell you that there's no overall harm done in the long run (I think, haha!). I definitely appreciate all the sacrifices my parents made even more (yes, I understand that not every kid had the "joyous" experience of getting to watch surgeries in the OR on Saturday mornings), now that I'm a parent too; my extended family was around a lot, and I have a childhood nanny who I also adore (and keep in touch with still).

Good luck in your search for the right everything for you and your family!

I am an aspiring doctor (undergrad-bio major). My DD is 2 and expecting a little boy in early Jan. Whenever I get lost or frustrated with school, family, life, plans....you name it ! I come here for support, Just reading about all of your sacrifices gives much more hope and sheds some light on my future. My gratitude goes to to all you -hardworking pre-med, starting your undergrad, in med-school, residency, fellowship...women thank you for sharing your stories I enjoy reading them

We are also a 2 physician family, both in family medicine. We had #1 at the very beginning of second year of residency (I was pregnant through most of intern year, yikes!). That first year after our son was born was the absolute hardest! I was ready to drop out of residency and had even started to calculate how many shifts I'd have to work at an acute care clinic to pay back my loans.

Fast forward 9 years, three kids and life is much better. It's still crazy hectic, but at least it's OUR crazy, hectic. We have some control over our schedules and work loads. Hubby and I have been in practice together (with his dad) for seven years, until he recently took a more administrative position elsewhere. I work part-time, about 25-30 hours/week. I have been lucky to be able to work my schedule around our family's needs and do my share of carpool, attending school events, etc.

The "outsourcing" comment above has been my salvation. Incredible nanny who is now also a "household manager"...she does the grocery shopping, packs school lunches and snacks among a million other things to keep our household functioning. We have someone who cleans and does laundry twice a week. It's worth paying for the household help for my own sanity and to be able to focus on the kids when I'm home.

It is possible to take a break if you need it, before starting residency. Remember that, as tough as it is, residency is short term and you want to make a career choice that will fit your needs and lifestyle for the long term. It's only worth it if you are enjoying what you do!

Any tips for a 27 year old hoping to get into medical school by 29/30? We want to have kids and I don't want to wait until I'm done with everything... What are some good times to have babies in medical school? Or is that such a silly question? I'm feeling a bit panicked about it all...lots of pressure to have kids because I really want them and also pressure on myself for myself to do what I've always wanted to do!

I'm one half of a two-physician family, my husband and I are both registrars (Australian term, kind of in between resident and attending). We are expecting our first baby next year and I am definitely going to drop to part-time (e.g. 0.5 load) when I go back to work 6 months later. This is because I really WANT to spend time with my children when they are young and contribute as much as I can to their learning and development, and also I am not hugely passionate about medicine (don't mind it, but don't LOVE it as a job, and especially the night shifts/on-calls).

I think ultimately it comes down to how much you love medicine and how much you want to be at home with your children. If you love medicine, you can make family work (e.g. the way you have been doing), and the joys from work will make it worthwhile. If you don't love it enough, you will feel increasingly frustrated at the time and attention it demands from you, and wonder whether it's worth it (kind of how I felt) - and then it's time to cut back.

Something else I realised is that it doesn't necessarily get better as an attending - that depends on the specialty - so examine the lives of your attendings to see what things will be like for you. If you can't see things improving in the future, it's better to change something now, rather than plough on simply because it's what's expected of you!

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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